Manifestation of pain syndrome in lumbar instability
Keywords:functional motion unit, instability, pain syndrome, neurological disorders
AbstractBackground. The article deals with the data on the results of the study and treatment of 57 patients with pain syndrome in lumbar instability. Patients received the inpatient treatment in the Spine Surgery Department of SI “Institute of Orthopedics of the NAMS of Ukraine”, Kyiv, from 2016 to 2018. Materials and methods. The study is based on an analysis of the results of the study and treatment of 57 patients with pain syndrome in lumbar instability. The study analyzed the patients’ medical histories, examination, observational radiography of spine in functional position, functional radiography of spine. Results. Patients were selected according to the following criteria: the presence of vertebrogenous pain and neurological syndrome, which manifested itself in sensory and motor impairments due to instability in the lumbar functional spinal unit. The discogenic instability (13 (22. 8 %) patients) is associated with intense pain at the level of lumbar functional spine unit, back muscle tension, physical inactivation at the level of damaged segments and adherent segments. The sympathetic syndrome, intensive pain in the functional unit, the tension in back muscles, restrictions of motions at the level of damaged and adherent segments are common in the discogenic instability (19 (33.3 %) patients). In disk arthrosis associated instability, the patients (29 (50.9 %)) developed a radicular syndrome, a moderate local pain (lumbago, lumbodynia), which increases with movement, changes of torso positions, restriction of motions, morning stiffness, decreased muscular strength in lower extremities, dysfunction of the pelvic organs. The disk arthritis osteogenic instability (9 (15.8 %) patients) was associated with clinical local pain, impaired motor function of a segment, the tendency to dislocation of the vertebra, or damage of spine components with symptoms of stenosis of spinal canal, radicular and vascular abnormalities, spinal deformity. Conclusions. Types of the instability of the lumbar motor segment are relative with the specificity of structural changes in the intervertebral discs, facet joints, and the interarticular part of the vertebra. Neurological manifestations depend on localization and degree of instability in the lumbar spine. Among the pain syndromes, nerve root pains (29 patients (50.9 %)) and lumbago (19 patients (33.3 %)) prevail. Spinal instability is followed by reflex syndromes. Reflex syndromes include lumbago in case of the acute or chronic progression of an illness, lumbodynia in case of subacute and chronicity. Radiculopathy is the most common disease among nerve root syndromes, radiculopathy occurred in 9 (15.8 %) patients.
Арестов С.О., Гуща А.О., Кащеев А.А. Алгоритм лечения пациентов с болями в области поясницы. Русский медицинский журнал. 2012. № 20(31). С. 1540-2.
Васильев А.Ю., Витько Н.К. Компьютерная томография в диагностике дегенеративных изменений позвоночника. Москва: Видар, 2000. 120 с.
Гиоев П.М. Прикладная анатомия и оперативная хирургия поясничного отдела позвоночника. СПб., 2006.
Жарков П.Л., Жарков А.П., Бубновский С.М. Поясничные боли. Москва: Юниарпринт, 2002. 143 с.
Коновалов Н.А., Назаренко А.Г., Асютин Д.С., Зеленков П.В., Оноприенко Р.А., Королишин В.А. и др. Современные методы лечения дегенеративных заболеваний межпозвонкового диска. Обзор литературы. Вопросы нейрохирургии им. Н.Н. Бурденко. 2016. № 4. С. 102-8.
Матвеев В.И. К вопросу об оценке качества жизни больных с поясничной болью. Актуальные вопросы вертебромедуллярной нейрохирургии: Сб. науч. тр. Балаково, 2003. С. 122-126.
Швец В.В. Поясничный остеохондроз. Некоторые аспекты патогенеза, хирургическое лечение: автореф. дис... д-ра мед. наук. Москва, 2008. 39 с.
Copyright (c) 2020 TRAUMA
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
- The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal.